Healthcare Provider Details

I. General information

NPI: 1316154651
Provider Name (Legal Business Name): MARIA I SERRANO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BARRIO BAYAMONCITO CARR 156 KM 40 1
AGUAS BUENAS PR
00703
US

IV. Provider business mailing address

APARTADO 439
AGUAS BUENAS PR
00703
US

V. Phone/Fax

Practice location:
  • Phone: 787-732-4099
  • Fax:
Mailing address:
  • Phone: 787-732-4099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number014350
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: